If you have an annoying and sometimes painful, lump on your wrist, it is most likely a ganglion cyst. These cysts are usually harmless, and most go away without treatment. However, if a ganglion cyst on your hand or foot is causing pain and limiting your mobility, consult Dr. Leon Reyfman about treatment options to get rid of this unsightly fluid-filled lump. He will explain what ganglion cysts are, what causes them, and recommends treatment and care based on how they are affecting your quality of life.
What Is a Ganglion Cyst?
A ganglion cyst is a fluid-filled lump just below the surface of your skin that appears on or near joints and tendons. This type of cyst can develop when you have a tear in the tissue that covers a tendon or joint. It causes the tissue to bulge and create a sac. Another name for a ganglion cyst is a bible cyst.The cyst can be the size and shape of a pea, but it can sometimes grow larger over time. These cysts do not cause any symptoms and may disappear on their own.
Ganglion cysts typically develop on the:
- Wrist – On the front or back
- Finger – Near any finger joint, close to the palm or just below the fingernail
- Foot – Close to your ankle or near the toes
Some ganglion cysts are so small that you may not see an obvious lump under your skin, but they still cause pain. They are known as occult ganglions, and it takes an ultrasound or an MRI to reveal them.
What Causes Ganglion Cysts?
Doctors are not sure what exactly causes ganglion cysts. It is believed they develop after a minor injury or trauma to a joint or tendon. As the joint tissue breaks down, it bulges and forms a small cyst or sac that creates a larger mass. Fluid from the joint leaks into the sac and causes swelling.
A flaw in the joint capsule or tendon sheath, layers of connective tissue that allow tendons to move smoothly over bones, can cause the joint tissues to bulge. Ganglion cysts occur commonly in children and adults.
Symptoms of Ganglion Cysts
Most ganglion cysts show up as a soft bump or mass under the skin that changes shape and size but does not move. They are often painless, but swelling may appear over time or suddenly.
Other symptoms include:
- One large cyst or many smaller cysts
- Some degree of pain, especially after an injury or trauma from repeated movement
- Long-lasting pain that gets worse when you move the affected joint
- Pressure on nerves that causes tingling or numbness
- Weakness in the affected finger if the cyst is connected to a tendon
- A bump that often goes away and comes back
How the cyst affects your life depends on the location and size of the cyst, as well as how it grows over time. They usually appear on the top or bottom side of the wrist but can also be on the feet, knees, and ankles. While some people may feel nothing, others may feel irritation, pain, or tingling if the cysts increase in size or press against nerves, ligaments, or arteries.
How Do You Tell if a Lump Is a Ganglion Cyst?
A ganglion cyst usually looks like a lump or bump on your wrist, finger, or foot, between 1/3 and 1 inch in diameter. It is stationary and can appear suddenly or gradually. The lump will be round or misshapen, more like an oval. It often changes sizes and even goes away.
A ganglion cyst sits just below the skin’s surface. It may look like a bubble blown from a joint. Ganglia sometimes have a translucent effect. You can see through the lump at certain angles.
Are Ganglion Cysts Benign or Malignant?
Although they appear as balls of fluid or lumps that grow on the membrane that covers tendons and joints, ganglion cysts are not malignant or cancerous. They are usually harmless and grow on the backs of the hands and wrists but sometimes develop on the feet, knees, and ankles.
Similar to benign tumors, ganglion cysts are asymptomatic, but some individuals experience pain, tenderness, decreased muscle tone, etc. Unlike benign tumors, cysts cannot progress to become malignant tumors.
How to Diagnose a Ganglion Cyst?
Ganglion cysts are very easy to diagnose. Their appearance and location, on the wrist or fingers, are telltale signs of ganglia. Your pain doctor will perform a physical examination of the affected area or body part, such as the hand or foot. He may press on the bump to check it or shine a light to see if it is translucent and detect abnormalities. If the light passes through the bump, it is much more likely to contain fluid and be a cyst.
Additionally, ultrasound or MRI can also be used to diagnose a cyst and distinguish it from a vascular malformation. At times, doctors recommend an x-ray to look for underlying joint arthritis near the cyst.
In some cases, your doctor may remove some fluid from inside the lump for further analysis in a process called biopsy.
Treating Ganglion Cyst
Ganglion cysts do not require treatment unless caused by an injury, or turn painful. Get them checked by your doctor to make sure they are indeed ganglion cysts and nothing serious.
After your ganglion cyst has been identified and diagnosed, your doctor may advise you to observe or monitor the cyst. Many cysts usually disappear over time. Also, inactivity or resting the wrist or foot may reduce the swelling and alleviate the pain.
Ganglion cyst treatments include:
- Anti-inflammatory medication – Medication can minimize swelling, and ease mild levels of discomfort.
- Splints or braces – They offer support and stop you from moving the affected area, reducing swelling and pain, and your ganglion may shrink and disappear on its own.
- Aspiration or drainage – Your doctor will use a needle to drain the fluid from the cysts. You will feel better right away. However, as the cyst cavity remains under the skin, chances are it will fill with fluid again after some time.
You should not try treating ganglion cysts at home by smashing the cyst with a book or heavy object. You may end up breaking a bone or otherwise injuring yourself, and the ganglion will return anyway. Also, do not poke the cyst with a pin or any other sharp object. You could cause an infection and other complications.
When Does a Ganglion Cyst Need Surgery?
Your doctor may recommend surgery if your ganglion cyst turns painful, other treatments do not provide relief, or your cyst keeps on coming back. The surgeon will extract the cyst and remove the area around it, as well as a stalk-like structure or root, that attaches it to the joint.
Ganglion cyst removal surgery is called ganglionectomy. It is usually an outpatient procedure. You can go home the same day. Full recovery may take two to six weeks. Extracting a cyst from the bottom of the wrist is a more complex procedure because of the nearby radial artery.
Getting your ganglion cyst removed surgically effectively resolves all your symptoms. In some cases, ganglia may come back.
What Happens if a Ganglion Cyst Is Left Untreated?
If a ganglion cyst does not bother, it may not need treatment. Most cysts go away on their own. Your doctor may tell you to keep an eye on it for any changes.
You may require treatment in case:
- A cyst presses against a nerve or joint tissue and causes pain
- Certain movements or tasks become difficult, such as gripping a pencil or walking
- You feel self-conscious about your appearance
A ganglion cyst may not require treatment if there are no troubling symptoms.
Are you interested in knowing more about ganglion cysts and their treatment options – Call Pain Management NYC today and schedule an appointment with Dr. Leon Reyfman for effective options to treat ganglion cysts. Dr. Reyfman understands how alarming a suspicious lump or mass on your hand or feet can be and examines the cyst carefully to make an accurate diagnosis based on your symptoms. He comes up with personalized treatment plans that focus on delivering the highest quality care for your individual needs and helps you make informed decisions regarding your well-being.
Boleslav Kosharskyy, MD, is a top-rated, best-in-class interventional pain management doctor. He is board-certified in Anesthesiology, Interventional Pain Medicine, and Palliative Care.
Dr. Kosharskyy is an Associate Professor of Anesthesiology and Rehabilitation Medicine at Albert Einstein Medical College. He’s also the Associate Medical Director of Pain Medicine and Director of Anesthesia for the Joint Replacement Center at Montefiore Medical Center and Albert Einstein Medical College.
He is an active member of the American Society of Anesthesiology (ASA), the American Society of Regional Anesthesia and Pain Medicine (ASRA), and the New York State Society of Anesthesiologists (NYSSA)